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Patient Coverage Representative
New Berlin, WI
Job Description
Ensures the verification of insurance information received from various points of contact, including patients, payors, and other team members (inside and outside the revenue cycle). Uses multiple tools in Epic to ensure information is updated, ensuring billing accuracy. Receives incoming calls from patients as well as business office team members to perform coverage updates. Updates information in the Electronic Health Record(s) (EHR) to ensure coverage is verified and accurate. Ensures appropriate steps are taken to initiate claims on affected transactions.Performs updates based on Visit Filing Order changes daily, ensuring claims are sent to the correct primary and/or secondary payor. Reviews electronic eligibility transactions returned for patients with upcoming services, as well as for services that have already been billed to the patient, performing the necessary updates to coverage as needed to ensure accuracy of coverage information. Sends and receives Customer Relationship Management requests (CRM) to communicate with other team members in the business office regarding patient-initiated insurance concerns. Follows up on patient-initiated insurance changes through the EHR Patient Portal and makes updates as necessary. Performs guarantor account updates based on patient-initiated requests, ensuring the appropriate guarantor type is being used based on billing requirements. Updates hospital account records (HARs) and visits to ensure Smart Chart identified data discrepancies are corrected. Works other EHR workqueues related to patient demographic, guarantor, and coverage information as needed. Scheduled Hours Monday through Friday 8:30am to 5:00pm This is a remote position, not on-site at an Advocate Aurora location. There may be occasional travel for department meetings or required training.Required Functional Experience Typically requires 2 years of experience in health care, with focus on registration, insurance, and billing. Knowledge, Skills & Abilities Knowledge and understanding of Revenue Cycle-specific insurance and billing procedures preferred. Previous data entry experience and demonstrated proficiency with emphasis on speed with accuracy. Knowledge of Medicare, Medicaid and third-party payors. Knowledge of medical terminology. Good organizational ability as well as solid written and verbal communication skills. A basic understanding of EHRs, with the ability to gain deeper knowledge. Licenses & Certifications None Required. Degrees High School Graduate.
Job Summary
Company
Advocate Health Care
Start Date
As soon as possible
Employment Term and Type
Regular, Full Time
Required Education
High School or Equivalent
Required Experience
2+ years
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